While the incidence of gastric and GEJ adenocarcinoma continues to rise, efficacious treatment options, especially in the previously treated metastatic setting, remain limited. Cyramza (Eli Lilly) and cytotoxic therapies are the mainstays of treatment, and new therapies, including Keytruda (Merck & Co.) and Lonsurf (Taiho Oncology), have recently been added to the armamentarium. Several new therapies, spanning novel drug classes, are in development, and if they can demonstrate greater survival benefits than the current standards of care, they could reap significant commercial rewards. The substantial unmet need for therapeutic management of previously treated metastatic gastric and GEJ adenocarcinoma with more-efficacious and well-tolerated novel therapies presents an attractive opportunity for drug developers.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for previously treated metastatic gastric and GEJ adenocarcinoma?
  • What attributes are key influencers, which have limited impact, and which are hidden opportunities for drug developers?
  • How do current therapies perform on key treatment drivers and goals for metastatic gastric and GEJ adenocarcinoma?
  • What are the prevailing areas of unmet need and opportunity in previously treated metastatic gastric and GEJ adenocarcinoma?

PRODUCT DESCRIPTION

Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Markets covered: United States, United Kingdom, France, Germany.

Primary research: Survey of 60 U.S. and 31 European medical oncologists.

Key drugs: Herceptin, Cyramza, Keytruda, Lonsurf.

Table of contents

  • Gastroesophageal Cancer - Unmet Need - Detailed, Expanded Analysis (US & EU) Previously Treated Metastatic Gastric And Gastroesophageal Junction (GEJ) Adenocarcinoma
    • Executive Summary
      • Unmet Need - Previously Treated Metastatic Gastric and Gastroesophageal Junction (GEJ) Adenocarcinoma- Executive Summary - July 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Regimens for Previously Treated Metastatic Gastric and Gastroesophageal Junction (GEJ) Adenocarcinoma and Rationale for Drug Selection
      • Treatment Drivers and Goals
        • Key Findings: Attribute Importance
        • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Oncologists' Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma
        • Importance of Efficacy Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
        • Key Findings: Stated vs. Derived Importance
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Overall Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
        • Mean Overall Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States and Europe
        • Relative Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Across Select Convenience of Administration Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma
        • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Previously Treated Metastatic Gastric and GEJ Adenocarcinoma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
        • Surveyed Medical oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma: Europe
        • Key Findings: Unmet Need in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma and Related Indications
        • Surveyed Medical oncologists' Ascribed Level of Unmet Need in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma and Related Indications: United States
        • Surveyed Medical oncologists' Ascribed Level of Unmet Need in Previously Treated Metastatic Gastric and GEJ Adenocarcinoma and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the Previously treated Metastatic Gastric and Gastroesophageal Junction (GEJ) Adenocarcinoma Market and Emerging Therapy Insights
          • Opportunity: A New Therapy with Extended Progression-Free Survival
          • Opportunity: A Novel Therapy That Improves Tumor Response
          • Opportunity: A Novel therapy with Improved Safety and Tolerability
      • Target Product Profiles
        • Assessing Drug Development Opportunities
        • Target Product Profile Methodology
          • Attributes and Attribute Levels
          • Assigned Prohibitions for the Conjoint Module
        • Attribute Importance and Part-Worth Utilities
          • Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Target Product Profile: Attribute Importance
          • Median Overall Survival
          • Median Progression-Free Survival
          • Objective Response Rate
          • Incidence of Grade 3/4 Hematological Toxicities
          • Incidence of Grade 3/4 Gastrointestinal Toxicities
          • Incidence of Treatment Discontinuations due to Adverse Events
          • Price per Cycle
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • Previously Treated Metastatic Gastric and GEJ Adenocarcinoma Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations
        • Bibliography

    Author(s): Snigdha Gupta, Ph.D

    Dr. Snigdha Gupta is a Lead Analyst in the oncology team at Decision Resources Group with expertise in multiple oncology indications including non-small cell lung cancer and multiple myeloma.

    Prior to joining DRG, Dr. Snigdha Gupta was a subject matter expert in immune-oncology, autoimmunity and dealt in generating in-depth framework based scientific analyses for client projects. In her previous organizations, she was involved in the planning and execution of the IND enabling preclinical studies. She has been instrumental in the stage-up of two small molecules at Bioxcel Therapeutics and Daiichi Sankyo Pharma India Pvt. Ltd. Dr. Gupta holds Ph.D. in infectious diseases from the Indian Institute of Chemical Biology, Jadavpur University, Kolkata while her post-doctoral fellowship is from the Mucosal immunology labs of National Institute of Immunology, New Delhi.


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